ABSTRACT
The prevalence and risk factors for acquisition of human T-cell lymphotropic virus type I and II (HTLV-I and II) were investigated in a prospective study of 913 injecting drug users (IDUs) in Stockholm in 1994. Epidemiologic data were recorded, and blood samples were tested for antibodies against HTLV-I and HTLV-II; human immunodeficiency virus (HIV) types 1 and 2; and hepatitis A (HAV), B (HBV), C (HCV), and D (HDV). Positive serologic results for HTLV were confirmed by Western blot (WB) and polymerase chain reaction (PCR). Of the 905 participants with conclusive HTLV-II status, 29 (3.2%) were HTLV-II positive, and all but three were of Nordic descent. None was HTLV-I infected. One person was infected as early as 1981, before HIV had reached the IDU population in Sweden. The prevalence of HTLV-II infection was 12% among HIV-1-seropositive and 1.8% among HIV-1-seronegative participants. The overall seroprevalences were 14% for HIV-1, 0% for HIV-2, 41% for HAV, 75% for HBV, 92% for HCV, and 8% for HDV. Although amphetamine has been the main injecting drug in Sweden for several decades, heroin abuse combined with a debut of injecting drugs before 1975 was identified as the most important risk factor associated with HTLV-II infection. HAV and HIV seropositivity were also independent risk factors.
Subject(s)
HTLV-II Infections/epidemiology , Substance Abuse, Intravenous/complications , Adult , Age Factors , Female , HIV Seropositivity/complications , HIV Seropositivity/epidemiology , HTLV-I Infections/epidemiology , HTLV-II Antibodies/blood , HTLV-II Infections/complications , Hepatitis A/complications , Hepatitis A/epidemiology , Hepatitis, Viral, Human/complications , Hepatitis, Viral, Human/epidemiology , Humans , Male , Prevalence , Prospective Studies , Risk Factors , Sweden/epidemiologySubject(s)
Heroin Dependence/epidemiology , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Sweden/epidemiologyABSTRACT
Structured interviews with 75 intravenous drug abusers (IVDAs) in Stockholm showed that, despite their having had several contacts with various medical institutions or prisons, none had been offered vaccination against hepatitis B virus (HBV) infection as recommended by the National Board of Health and Welfare. We conclude that, as failure to offer HBV vaccination to IVDAs contributes to be continued spread of HBV infection in this category, at admission all IVDAs should undergo serological HBV-testing and vaccination be offered to HBV-negatives.
Subject(s)
Hepatitis B Vaccines/supply & distribution , Hepatitis B/transmission , Substance Abuse, Intravenous/complications , Adult , Female , Hepatitis B/immunology , Hepatitis B/prevention & control , Hepatitis B Vaccines/administration & dosage , Humans , Male , Middle Aged , Substance Abuse, Intravenous/immunology , Surveys and Questionnaires , SwedenABSTRACT
In order to study the importance of sexual transmission of hepatitis B virus (HBV) among intravenous drug abusers (IVDAs), and from IVDAs to others, we consecutively interviewed 171 IVDAs detained at the Stockholm Remand Prison during 4 months in 1990. Sexual histories revealed that 77% reported > or = 3 sexual partners during the last 3 years, 64% had had a sexual partner who did not inject drugs, and 61% reported a prior STD. The prevalence of HBV markers was 75%. In a multiple logistic regression analysis, a high risk for HBV markers was associated with an increasing duration of drug abuse, a high prevalence of hepatitis A markers, and an increasing number of drug injecting sexual partners during the last 3 years, indicating that sexual transmission, along with sharing of needles, may contribute to the high prevalence of HBV markers within this group. It is suggested that an adequate sexual history must be obtained from IVDAs with acute viral hepatitis in order to identify sexual partners who should be offered postexposure prophylaxis, and that non-immune IVDAs should be vaccinated against viral hepatitis A and B.
